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<p>The percentage of patients with interstitial lung disease (ILD) associated with systemic autoimmune diseases, such as rheumatoid arthritis (RA), systemic sclerosis, systemic lupus erythematosus (SLE), or mixed connective tissue disease (MCTD), continues to increase in patients undergoing lung transplantation (LuTX). LuTX is often the only treatment option for this patient collective. Compared to patients with interstitial lung fibrosis, similar results in LuTX studies regarding rejection reactions, outcome, and survival were achieved; thus, rheumatic diseases do not represent a&#xa0;contraindication for LuTX. On the contrary, LuTX for this patient population is a safe and effective treatment option. Possible comorbidities (e.g., gastroesophageal reflux and aspiration, renal involvement, vascular and cutaneous manifestations, and if applicable immunosuppression due to the underlying disease and specific oncological risks) pose particular challenges in LuTX management. In general, early referral to a transplantation center, multidisciplinary assessments focusing on extrapulmonary manifestations, individual tailoring of immunosuppression, interdisciplinary rheumatologic care, and a&#xa0;specific aftercare program are important. The Vienna LuTX program, one of the largest in Europa, has many years of experience in LuTX treatment, including patients with rheumatic diseases. In the present article, we present Vienna LuTX data, critically examine the international literature, and derive recommendations for managing this specific group of patients.</p>

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Lungentransplantation bei Patient:innen mit rheumatologischen Erkrankungen

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月31日

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  • Peter Jaksch,
  • Ecevit Uzunkaya

摘要

The percentage of patients with interstitial lung disease (ILD) associated with systemic autoimmune diseases, such as rheumatoid arthritis (RA), systemic sclerosis, systemic lupus erythematosus (SLE), or mixed connective tissue disease (MCTD), continues to increase in patients undergoing lung transplantation (LuTX). LuTX is often the only treatment option for this patient collective. Compared to patients with interstitial lung fibrosis, similar results in LuTX studies regarding rejection reactions, outcome, and survival were achieved; thus, rheumatic diseases do not represent a contraindication for LuTX. On the contrary, LuTX for this patient population is a safe and effective treatment option. Possible comorbidities (e.g., gastroesophageal reflux and aspiration, renal involvement, vascular and cutaneous manifestations, and if applicable immunosuppression due to the underlying disease and specific oncological risks) pose particular challenges in LuTX management. In general, early referral to a transplantation center, multidisciplinary assessments focusing on extrapulmonary manifestations, individual tailoring of immunosuppression, interdisciplinary rheumatologic care, and a specific aftercare program are important. The Vienna LuTX program, one of the largest in Europa, has many years of experience in LuTX treatment, including patients with rheumatic diseases. In the present article, we present Vienna LuTX data, critically examine the international literature, and derive recommendations for managing this specific group of patients.